Studies of the angular reproducibility of positioning patients adjacent to an x-ray tube: 1. Stent-rod based and extra-oral systems

The usefulness of subtraction radiography for detecting small changes in crestal bone is dependent upon achieving reproducible geometry between x-ray beam and patient structures when serial radiographs are taken. This study evaluates 2 methods currently employed to maintain geometric correspondence: 1) a stent-based system which rigidly fixes a custom-made stent to the x-ray tube by the use of a rod and 2) an extra-oral system which positions a patient in the x-ray unit by means of ear rods. The projection of a light beam from a fixed subject reference was used to measure the change of the orientation of the reference at 2 different measurement times. The rod-stent system was able to maintain a discrepancy of less than 2 75% of the time over a time period of 6 months. For the extra-oral system this ranged from 72% to 92% during a 1-month period.